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433 Sargo Rd Roof 2013 CITY OF ATLANTIC BEACH J 800 SEMINOLE ROAD ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5814 SA Application Number . . . . . 13-00002947 Date 6/26/13 Property Address . . . . . . 433 SARGO RD Application type description ROOF PERMIT Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 5700 ------------------------------------------------------ Application desc reroof ------------------------------------------------ Owner Contractor - ------------------------ ----------------------- WOODWARD, DOLPHUS J HOUSE DOCTORS CONSTRUCTION INC 433 SARGO ROAD 5782 SAWYER AVE ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32208 (904) 405-3817 ------------------------------------------------- Permit . . . . . . ROOF PERMIT Additional desc . Permit Fee 80 . 00 Plan Check Fee . 00 Issue Date . . . Valuation 5700 Expiration Date . . 12/23/13 ----------------------------------------------- Special Notes and Comments need gl and need noc --------------------- --------------------------- Other Fees . . . . . . . . . STATE DCA SURCHARGE 2 . 00 STATE DBPR SURCHARGE 2 . 00 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----- ---------- ---------- Permit Fee Total 80 . 00 80 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Other Fee Total 4 . 00 4 . 00 . 00 . 00 Grand Total 84 . 00 84 . 00 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. BUILDING PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Road, Atlantic Beach, FL 32233 Office (904) 247-5826 Fax (904) 247-5845 Job Address: S A G Permit Number: Legal Description Parcel# Floor Area of Sq.Ft. q. t Valuation of Work$ S?ov. C1 d Proposed Work heated/cooled non-heated/cooled Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa window/door Use of existing/proposed structure(s)(circle one): Commercial Residential If an existing structure,is a fire sprinkler system inst lied? (Circle one): Yes No N/A Florida Product Approval# L For multiple products use product approva orm Describe in detail the type of work to be performed: — /Z ool� Property Owner Info1rmation: n Name: VWf— �v 1/� S U�� 1� AAAddress: '�)f Qom( © City A .j, State�ZZip 322.3 Phone 9 o 4- lQ 4 Cl % )Coo S E-Mail or Fax#(Optional) Contractor Information: Company Name: 1:"A- ' Qualifying Agent: Address:�78Z gke A&I City State Zip Office PhoM! 4�� 17 Job Site/Contact Number 405`3?-1 7 Fax# State Certification/Registration# Architect Name&Phone# Engineer's Name&Phone# Fee Simple Title Holder Name and Address Bonding Company Name and Address Mortgage Lender Name and Address Application is hereby made to obtain a permit to do the work and installations as indicated. 1 certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in thisjurisdiction. This permit becomes null and void if work is not commenced within six(6)months, or if construction or work is suspended or abandoned for a_period of six6)months at any time after work is commenced. I understand that separate permits must be secured for Electrical Work, Plumbing,Signs, Wells, Pools, urnaces,Boilers, Heaters, Tanks and Air Conditioners,etc. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. I hereb certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type q/1 k will be complied with whether sped ied herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other federal,state, or local law regulating construction or the performance of construction. ` Signature of Owner � Signature of Contractor Print Name Print Name ......... c�5�.1.! 'C.......... ............ Befo Befor thi ay HI 0 this D y f 20 13 MV I 14,2p14 Publlc Notary Public ,� t 1 14,2014 8 22-'7 Z 9 ^ ypidedThruNotaiY u�o vyse-110.24.12 a _ _ _ O 4043617433 » Building Dept. P 1/1 NOTICE 2013-07-01 15:'52 WellsFargo Bank, NA OF COMMENCEMENT �7 (PREPARE IN DUPLICATE) Permit No.=D0pp L Tax Folio No. State of County of To whom it may concern: The undersigned hereby informs you that improvements will be made to certain real property,and in accordance with Section 713 of the Florida Statutes,the following information is stated in this NOTICE,OF COMMENCEMENT. Legal description of property being improved: Address of property being improved: General description of improvements: '— I> Y Owner Address ' Owner's interest in site of the improvement Fee Simple Titleholder(if other than owner) Name Address b I`x c; I r Contractor Address Phone No. tri Fax No. Surety (if any) Amount of bond$ Address Fax Na. Phone No. _ Name and address of any person making a loan for the construction of the improvements. Name Address Phone No. Fax No. Name of person within the State of Florida, other than himself, designated by owner upon whom notices or other documents may be served: Name Address Fax No. Phone No. In addition to himself, owner designates the following person to receive a copy of the Lienor's Notice as provided in Section 713.06(2)(b), Florida Statutes. (Fill in at Owner's option). Name Address Phone No. Fax No. Expiration date of Notice of Commencement(the expiration date is one (1) year from the date of recording unless a different date is specified): OWNER THIS SPACE FOR RECORDER'S IISF ONLY DATE L 14 13 Slgnod: t in the Docu 2013163 ,OR BK 16427 Pa9©2292, Seforo mo is day Number Pa9es',1 Cou Duva,State of Florida,has personally appeared Recoroed 06126+'2013 at 12,18 Pm, p+a �.,�g�7voe��.s heroin by Ronnie Fus5011 CLERK CIRCUI-r COURT DUVAL himself)herself And affirms that all statements and deGarations Herein COUNTY are truo and accurate ♦ �p�� RF_CORDING$10.00 POW OfAwift 10 Notary Public at Large,State of F to♦ , My commission expires; or Personally Known NQ Producod Identification